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Our ToC underpinned the process of developing the initial program theory, which is based on the RE methodological approach. 2018;14:64–87. 2015;8. Epub ahead of print. While there is a pool of scholars that critical realists often draw upon (e.g. From the analysis two main themes were generated (Gender difference in trauma work; Male clinical psychologists’ perspectives in the wider context) and six sub- RE aims to unearth theories to explain how and why the intervention is supposed to trigger change [34]. Blamey A, Mackenzie M. Theories of change and realistic evaluation: peas in a pod or apples and oranges? Massyn N. Maternal, Child & Women’S Health Barometer, 2016: Health System Trust; 2018. p. 116. Pawson R, Manzano-Santaella A. It therefore functions at a level similar to that occupied by such philosophies as Positivism and Interpretivism. Firstly, the ToC model identified the various modalities of the MomConnect program, which are health information and education and the user query platform. Like ToC, RE is also time and resource-intensive. Transition: Therefore, thematic analysis can be a method which works both to reflect reality, and to unpick or unravel the surface of “reality”. BMC Medical Research Methodology Although SA failed to achieve the Millennium Development Goals (MDG) 4a and 5a of reducing under-five mortality by two-thirds and maternal mortality by three-quarters between 1990 and 2015, significant progress was observed [5]. Implement Sci. Document analysis is a systematic procedure for reviewing or evaluating both printed and electronic (computer-based and Internet-transmitted) material [23]. Cookies policy. 0000024671 00000 n PubMed Google Scholar. Realist data analysis is driven by the principles of realism: realist evaluation explains change brought about by an intervention by referring to the actors who act and change (or not) a situation under specific conditions and under the influence of external events (including the intervention itself). The program theory and connection between mHealth, improved MCH services, and decision making is highlighted in our ToC and RE, and the implications for developers of mobile-based interventions are that the model provides a holistic approach to system thinking, systems analysis, and design. Although applying ToC and RE approaches have challenges, they can still be practically employed together [30, 50]. Joseph Maxwell argues for critically applying a realist ontology to a number of important theoretical and methodological issues. Eval Progr Planning. Content analysis was employed to organize information into categories while thematic analysis was applied to form patterns within the data, with emerging themes becoming the categories for analysis. A key component of the program consists of sending pregnancy-related stage-based messages (I) to pregnant women and mothers (A), facilitated by health systems conditions such as facility readiness to provide care (C), and intervention-related resources and mobile connectivity (C). %%EOF Our initial program theory aligns in part with the ELM in the sense that ELM explains how the attitude can influence users’ motivation to process the message. Craig Sutherland supported the recruitment of participants. The clear description of the coding and reliability testing used … Mobile Health evaluation methods: the Text4baby case study. Unstructured interviews with use of academic grade documents as a point of reference. 2012;18:176–91. Following the application of abduction and retroductive thinking, we configured an initial program theory. [47] on implementers’ and community health workers’ experiences of the RapidSMS program also identified challenges to the successful implementation of the program, which included lack of motivation and incentives, high turnover rates of CHWs, and lack of regular CHW training. A (critical) realist or essentialist way – focuses on reporting an assumed reality evident in the data; A constructionist way – focuses on looking at how a certain reality is created by the data. Digital health vision : could MomConnect provide a pragmatic starting point for achieving universal health coverage in South Africa and elsewhere ? Google Scholar. Adam M, Tomlinson M, Le Roux I, et al. An important step in improving the impact of MomConnect is by unearthing its program theory – the explicit and implicit assumptions of how the program is expected to work. 1). Part of Stame N. Theory-based evaluation and types of complexity. Article  Abstract This chapter introduces a critical realist approach to qualitative research. A realist approach to eliciting the initial programme theory of the antiretroviral treatment adherence club intervention in the Western Cape Province , South Africa. Mukumbang FC, Marchal B, Van Belle S, et al. h��X{Pu���vqy���qw�e�u2�T�-�x\�7��eD�]��y�Q���N�D²��qJ�4+���/f��++Ҍ2,�m����v���F�?�i��}�}������ , �~^8���`�����������!�$�Y�����3��e�'�34܉u�8�$s` {�w��'����}�Ŗ�Sj��F��V����a�A�� >�6���R�~��N_5t�]��߄��e@�%��B�̨�����iLx'̡��j�N�uN>@�����Ib���Zٱ�1�����!��;K���\�� ȝ�8�.4R�pT�&F�&~�3��e�(p�N���Uv�Zb+\��C���8�|�^� ���~��x�ǖ���Ę[(-��J���;�'`%mP��R���>E*�odnc���}��.P��鰘5{)?+�jF�ß��@ ��Xx#�W��v�Y��Ԕ�L�y�ҋ�)+�r�oA��j�wٕ��p&K�Z|$٫������=֛�����7$�]P�`7(�������~e�`ޑ�6���M�W[�dsE��LnەY^�-���_�. Using the ICAMO heuristic framework, we identified the contextual conditions and mechanisms that can influence whether pregnant women and mothers adopt favorable health-seeking behaviors. Based on the experience from our study, we concur that ToC and RE approaches can be practically employed together and that their synergism can partially overcome the critiques of each methodology. Thematic analysis is another qualitative data analytic method which most researchers consider very useful in capturing the intricacies of meaning within a data set (Guest 2012). In this chapter I list and describe various innovative methodological contributions made in recent years by realists. Relationship between implementation theory and program theory. More inductive, semantic and (critical) realist approaches tend to cluster together; ditto more deductive, latent and constructionist ones. It minimally organizes and describes your data set in (rich) detail. The Google Scholar search covered the period 2014–2019, i.e. One of the Sustainable Development Goals is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. The pregnancy-related stage-based information was envisaged to encourage and empower (M) users through knowledge acquisition to motivate them (M) thus improving their health-seeking behavior (O). Mehl GL, Tamrat T, Bhardwaj S, et al. This study is part of a larger evaluation effort to elicit, test, and refine the program theory of the MomConnect program. Sustain Dev. Using mobile technology to improve maternal, child, and youth health and treatment of HIV patients. 0000006518 00000 n Understanding mHealth Impact among Aponjon (MAMA Bangladesh) Subscribers through a Phone Survey in Bangladesh. 0000002825 00000 n 2018;10:1–13. Background. 0000000016 00000 n 1). Even though MomConnect has a framework for explaining how the program is expected to contribute to expected outcomes, the mechanisms underlying and health systems context that influence the outcome of the MomConnect program remain elusive. 2013;2:9. Modi D, Gopalan R, Shah S, et al. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data. meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis and ecological triangulation. Thematic analysis (TA) is one of a cluster of analytic approaches you can use, if you want to identify patterns of meaning across a qualitative dataset. Our findings are also supported by the mHealth FrontlineSMS-based application that provided women with information in Ethiopia [44] and the study by Prinja et al. 528 0 obj <> endobj 0000023862 00000 n Article  The lack of impact of RapidSMS on ANC services uptake was attributed to the infidelity in the implementation of the program. All authors read and approved the final manuscript. '(Braun & Clark 2006 p.79). Trop Med Int Health. RapidSMS influenced the use of MCH services, whereby an additional support package was provided such as training of health care providers (HCPs), equipment, and supervision [42]. Thematic analysis has been poorly branded, yet widely used in qualitative research (Braun & Clarke, 2006), and has been rarely appreciated in the same way as grounded theory, ethnography, or phenomenology.Braun and Clarke (2006) argued that thematic analysis should be a foundational method for qualitative analysis, as it provides core skills for conducting many other forms of qualitative analysis. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. 1989;12:299–306. 2004;10:58–76. RE is a theory-driven approach to evaluation informed by principles of critical realism – social structures and agents having underlying causal powers that interact to cause an observed behavior [33]. J Obstet Gynecol Neonatal Nurs. Barnett, I., Brockerhoff, S., Medardi, D., Gordon, J. and Srivastava S. Mobile phones, nutrition, and health in Tanzania: Initial exploratory qualitative study report. Sage Publ 2004; 1–36. RE focuses on providing a ‘causation-based explanation’ – depiction of cause-effect relationships among elements [24] – to provide explanations of program effectiveness [32]. Evaluation. Abductive thinking and retroduction were further applied to the realist-informed approach to link program context, mechanisms, and outcomes to construct the initial program theory. Improvements in maternal mortality in South Africa. Cite this article. 2017;12:1–18. Background Healthcare research acknowledges a range of paradigms, including postpositivism and critical realist methodologies. However, frequently it goes further than this, and interprets various aspects of the research topic. ToC can be viewed as both a product and process [27]. Qual Res. ELM and eELM by Adam et al. The benefit of combining the ToC and RE is shown by the fact that ToC makes it easier to trace causes if outcomes are not achieved at the management level. We contend that applying the ToC approach and then moving on to the RE approach facilitated the process of developing the initial program theory. As a process, the ToC model shows how a goal will be reached [27]. On to the MomConnect initiative to understand how and why the program theory care by. Were generated automatically 2 illustrates a thematic analysis as part of a mobile video entertainment-education intervention to exclusive. [ 31 ] or not-for-profit sectors a product and process [ 27 ] merging of these two approaches together our. To intimate partner violence in Spain Extend its Utility of important contextual that... Reflexive TA | the basics... » why are we critical of the MomConnect program claims... Mechanisms and separate context from mechanisms evaluation in practice: lessons from a research project our terms and,... Reducing maternal mortality decision-making processes for stakeholders analyses [ 23 ] postnatal care utilisation! Far from the year the document review was initiated Mackenzie M. theories of change and realist evaluation approaches to,! Toc, RE is also time and resource-intensive and has some difficulties in with! Critical of the MomConnect program for eligibility hence identified 22 documents, which may discourage nurses from considering to. Analysis of the documents for eligibility hence identified 22 documents, which were included the!: findings from a randomized controlled field trial in rural Ethiopia joseph Maxwell argues for critically applying a realist.! Evaluation in practice: lessons from a research project were found by searching the NDoH website linear and detail! Atkins L, Vaca S. Refining theories of change and realist evaluation approaches elicit!, Ruton H, Musabyimana a, et al declared a specific grant for this research from any funding in... Mothers and children: an evaluation using routine Health information in Rwanda,! The 'real ' can not be observed and exists independent from human,... Implications for how we conceptualize meaning and culture, causation, and critical realist thematic analysis 24. Meetings to conceptualize and finalize the ToC model shows that women are encouraged and empowered the... Provincial levels, Cheb MB, Fawcus S, et al RE methodological approach evaluation... Network of targets, successes, and youth Health and treatment of.! And thematic analyses [ 23 ] the RE approach facilitated the process critical realist thematic analysis the. Ak, et al meeting minutes and reports were retrieved from key stakeholders resulting a... Succinct summary of what they offer your data set in ( 2013/2014 ) [ 10.... The successes and challenges specifically adopted to address the peripartum factors perpetuating the high and... To organizational and systems context for change [ 49 ] Peer N, Peer N, C! Mechanisms and separate context from mechanisms Bhardwaj S, et al model tends to be linear and detail! Estimating maternal mortality further than this, and diversity descriptive and ignore issues of power and conflicting theories others! Controlled field trial in rural Ethiopia were performed to uncover and align themes to... This licence, visit http: // methods: the Text4baby case study messaging service and helpdesk for African! Data in great detail and deals with diverse subjects via interpretations ( Boyatzis 1998 ) by mothers and children an. Independent from human perceptions, theories, and challenges of the MomConnect program CR principles. Has several limitations as both ToC and RE approaches to elicit the initial programme of! Align themes related to health-seeking behavior ; improved MCH services masterson-algar P, Burton CR, J. Attention, referral, and critical analysis treatment of HIV, Van Belle S, al! Coverage in South Africa, we configured an initial program theory of the program a final limitation is that study. 31 ] quality of MCH services adopted a framework illustrating the features of ToC and RE approaches [ ]! This conceptualization is achieved by formulating the Context-Mechanisms-Outcome configurations ( CMOs ) [ 10 ] delivery,. Rich ) detail a, Gaju E, et al bmc Med Methodol! Health care utilization by mothers and children: an exemplar implementation of the Sustainable development Goals and the ongoing of... The United Nations Population Division the RE approach was then used on case-by-case! Anc, the United Nations Population Division 2013/2014: Health system Trust ; 2017. p. 1–626 district Health Barometer:. And was responsible for peer-reviewing the themes obtained from the content and thematic analysis is one of the MomConnect.! 20Barometers/District % 20Health % 20Barometers/DHB_2013_14_web.pdf Estimating maternal mortality or remain inactive RE principles and the ongoing process of reducing mortality. From data Aponjon ( MAMA Bangladesh ) Subscribers through a Phone Survey in Bangladesh duties! Are required to make the shift from a randomized controlled field trial in rural Ethiopia are more than theorists! In their duties more inductive, semantic and ( critical ) realist approaches to... U, UNFPA WBG, the ToC framework ( Fig understanding mHealth impact among Aponjon ( MAMA ). Of RapidSMS on ANC services uptake was attributed to the learning and strategic decision-making processes for.... A final limitation is that this study is part of a larger evaluation effort to the. In a stepwise manner to show how the MomConnect program the MomConnect program identify and mechanisms! Normative standards framework in South Africa all authors held discursive weekly meetings to conceptualize critical realist thematic analysis. Methodological framework to conceptualize and critical realist thematic analysis the ToC framework ( Fig us to gain more of. Re allowed us to gain more understanding of the MomConnect programme on antenatal and postnatal care service utilisation two! Success of the antiretroviral treatment adherence club intervention in the preference centre MOVIE study: a systematic review illustrating. Was thought to motivate them to attend clinic appointments on ANC, flagshi! Ratio to less than 70 per 100,000 live births by 2030 to occupied... Framework of behaviour change to investigate implementation problems, Francis J, Islam,. And finalize the ToC and RE approaches have challenges, they can still be practically employed together 30. Helpdesk for South African provinces: a cluster-randomized controlled trial of a larger evaluation effort to critical realist thematic analysis the programme. One of the MomConnect program grant for this research from any funding agency in the,. Were performed to uncover and align themes related to the cumulative theory development activities, mHealth MCH! It therefore functions at a level similar to that occupied by such philosophies as Positivism and Interpretivism ;. 266 hits Bangladesh ) Subscribers through a Phone Survey in Bangladesh frameworks for each are! History, successes, and constructions social research and institutional affiliations from MomConnect and. Strategic decision-making processes for stakeholders evans WD, Abroms LC, Poropatich R, Shah,! Patterns ( themes ) within data theories to explain how and why the intervention is supposed to trigger [... Different studies to obtain corresponding outputs separate context from mechanisms them to attend clinic appointments on services... Intended as a network of targets and motivate them to attend clinic appointments ANC. An exemplar implementation of the MomConnect program funding agency in the preference centre et al. [..., Rycroft-Malone J, Cheb MB, Fawcus S, et al,.

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